Journal Article

Analgesic nephropathy in Hungary: the HANS study

István Pintér, János Mátyus, Zoltán Czégány, Judit Harsányi, Marietta Homoki, Miklós Kassai, Éva Kiss, István Kiss, Erzsébet Ladányi, Lajos Lőcsey, Lajos Major, Mihály Misz, Lajos Nagy, Kálmán Polner, Jenő Rédl, István Solt, Béla Tichy, Marietta Török, Gábor Varga, Gyula Wagner, Imre Wórum, Béla Zsoldos, László Pótó, Katalin Dérczy, István Wittmann and Judit Nagy

in Nephrology Dialysis Transplantation

Published on behalf of European Renal Association - European Dialysis and Transplant Assoc

Volume 19, issue 4, pages 840-843
Published in print April 2004 | ISSN: 0931-0509
Published online April 2004 | e-ISSN: 1460-2385 | DOI: http://dx.doi.org/10.1093/ndt/gfh040
Analgesic nephropathy in Hungary: the HANS study

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Background. The diagnosis of analgesic nephropathy has improved significantly with modern imaging techniques. We reviewed a large portion of the Hungarian dialysis population to obtain additional insight into the problem.

Methods. Twenty-two participating dialysis units enrolled 1400 patients on renal replacement therapy between 1 January 1995 and 1 January 1998. Patients with no known aetiology (n = 284) were interviewed and studied with renal imaging. We assessed the presence of decreased renal mass combined with either bumpy contours, papillary calcification, or both. The subjects studied were interrogated extensively.

Results. Our survey suggested analgesic nephropathy in 47 of 1400 patients (3.3%), 3-fold higher than the EDTA database estimate for Hungary. The analgesics most commonly abused were phenacetin-containing mixtures. The driving symptoms were mainly headache and joint pain. Cardiovascular complications were more common than in the rest of the dialysis population, independent of smoking and lipid values (P<0.01).

Conclusions. Phenacetin should be banned. Our study results support the need for longitudinal cohort and case–control studies in Hungary.

Keywords: analgesic nephropathy; Hungary; renal replacement therapy

Journal Article.  2194 words.  Illustrated.

Subjects: Nephrology

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